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目的了解四川省西昌市艾滋病抗病毒治疗患者的病死情况和影响因素。方法使用国家“艾滋病综合防治信息系统——抗病毒治疗管理”数据库的基本情况和随访用药表,筛选出2009-2012年西昌市开始参加国家免费抗病毒治疗患者的生存、死亡信息,采用Cox比例风险回归模型对影响抗病毒治疗患者病死率的相关因素进行分析。结果在466例参加抗病毒治疗的艾滋病患者中,年龄中位数为35岁(四分位数间距:29~42岁),男性占83.9%(391/466),已婚或同居48.3%(225/466),静脉吸毒传播52.2%(243/466),异性性传播43.6%(203/466),开始抗病毒治疗前CD4+T淋巴细胞计数中位数为272个/μl(四分位数间距:191~326个/μl)。截至2013-12-31,累计死亡36例,病死率为4.0/1 0 0人年。Cox回归分析结果显示接受抗病毒治疗患者主要的死亡风险是抗病毒治疗前出现艾滋病相关疾病或症状(HR=2.9,95%CI:1.4-5.7)和CD4+T淋巴细胞计数<2 0 0个/μl(HR=2.3,9 5%CI:1.1-4.6)。结论四川省西昌市的艾滋病患者开展抗病毒治疗有效地降低病死率,早期及时地开始抗病毒治疗是降低艾滋病病死率的关键。
Objective To understand the mortality and influencing factors of AIDS patients in Xichang City, Sichuan Province. Methods According to the basic situation and follow-up medication table of the national “Integrated HIV / AIDS Prevention and Control Information System - Antiviral Treatment and Management” database, the survival and death information of the patients who started to participate in the national free anti-virus treatment from 2009 to 2012 was screened out. Cox proportional hazards regression model of factors affecting the mortality of patients with antiviral therapy were analyzed. Results Among 466 HIV-infected AIDS patients, the median age was 35 years (interquartile range: 29-42 years), 83.9% (391/466) men, 48.3% married or cohabited 225/466), intravenous drug use 52.2% (243/466), heterosexual transmission 43.6% (203/466), and median CD4 + T lymphocytes count before initiation of antiviral therapy was 272 cells / μl Number of spacing: 191 ~ 326 / μl). As of December 31, 2013, a total of 36 deaths were reported, with a mortality rate of 4.0 / 100 person-years. The Cox regression analysis showed that the major risk of death in patients receiving antiviral therapy was AIDS-related disease or symptoms (HR 2.9, 95% CI 1.4-5.7) and CD4 + T lymphocyte counts <200 / μl (HR = 2.3, 95% CI: 1.1-4.6). Conclusions Antiviral treatment of AIDS patients in Xichang, Sichuan Province effectively reduces the case fatality rate. Early and timely initiation of antiviral treatment is the key to reducing AIDS mortality.